Inulin significantly improves serum magnesium levels in proton pump inhibitor-induced hypomagnesaemia

Summary

Background

Proton pump inhibitors (PPI) are among the most widely prescribed drugs to treat gastric acid-related disorders. PPI-induced hypomagnesaemia, a defect in intestinal absorption of Mg²⁺, can be a severe side effect of chronic PPI use.

Aim

To restore serum Mg²⁺ concentrations in PPI-induced hypomagnesaemia patients by dietary supplementation with inulin fibres.

Methods

Eleven patients with PPI-induced hypomagnesaemia and 10 controls were treated with inulin (20 g/day). Each trial consisted of two cycles of 14-day inulin treatment followed by a washout period of 14 days. Patients continued to use their PPI. Serum Mg²⁺ levels served as the primary endpoint.

Results

Inulin significantly enhanced serum Mg²⁺ levels from 0.60 to 0.68 mmol/L in PPI-induced hypomagnesaemia patients, and from 0.84 to 0.93 mmol/L in controls. As a consequence 24 h urinary Mg²⁺ excretion was significantly increased in patients with PPI-induced hypomagnesaemia (0.3–2.2 mmol/day). Symptoms related to hypomagnesaemia, including muscle cramps and paraesthesia, were reduced during intervention with inulin.

Conclusion

Inulin increases serum Mg²⁺ concentrations under PPI maintenance in patients with PPI-induced hypomagnesaemia.

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